Women in Canadian medicine consistently earn less than men. The pay gap exists within every medical specialty as well as between specialties: physicians in male-dominated areas receive higher remuneration. These were some of the facts used as background for an International Women’s Day presentation on Gender Equity in Medicine presented by the VCH Medical Staff Diversity, Equity and Inclusion (DEI) initiative that VPSA supports. Drs. Tara Kiran and Michelle Cohen shared findings from their Closing the Gender Pay Gap in Medicine article published in the August 2020 issue of the Canadian Medical Journal Association. They reviewed the data, the root causes of the pay gap, and then joined in a discussion on potential solutions and next steps.
“The gender pay gap in medicine is not explained by women working fewer hours or less efficiently, but rather by systemic biases in medical school, hiring, promotion, clinical care arrangements, the fee structure itself, and societal structures,” commented Dr. Kiran.
A CMA national physician survey in 2019 found that women worked 4.7 per cent fewer hours per week and 8.6 per cent fewer hours on call. A study from BC in 2017 reported that women physicians made 36 per cent less than men; their patient care workload differed by only 3.2 hours per week.
“The disparities related more to the type of work and how that work is valued,” said Dr. Kiran.
The pay gap, the presenters pointed out, relates to sexism and discrimination that occurs throughout a physician’s career. These begin in medical school, and continue with unconscious bias in recruitment, hiring, starting salaries and negotiations, and is reinforced by clinical care arrangements, promotion, and leadership opportunities. Added to this is most domestic responsibilities are shouldered by women.
There are some concrete steps we can take to address the gender pay gap in medicine.
“We need more data; we’re missing a lot of information and doing the best we can with what we’ve got,” said Dr. Cohen. “Standard, fair, and transparent hiring and promotion practices are areas that should be prioritized. Leadership roles need to be advertised transparently. There needs to be gender parity on selection committees.”
Other positive actions include anti-oppression training for board members, leadership, and senior staff, actively seeking women for leadership roles, and better maternity and parental leave programs.
“Through the VCH Diversity, Equity and Inclusion (DEI) Committee and in collaboration with Medical Affairs, we are addressing many of the issues raised by Dr. Kiran and Dr. Cohen,” said Dr. Sophia Park, co-chair of the committee’s Leadership Skills, Talent Management and Succession Planning Working Group. “Job descriptions for medical leadership are under review with a diversity and equity lens, and VCH is comparing job templates used by divisions, departments, and regional medical programs. VCH is also considering changes to the search and selection process for medical leaders, with a focus on implementing DEI best practices. We are particularly pleased that unconscious bias training is being developed for those who sit on selection committees.”